- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,756.40 / $7,756.40 / $7,838.98
| Facility | | $7,756.40 | $7,756.40 | $7,838.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,108.85 / $7,756.40 / $8,314.45
| Professional | | $7,108.85 | $7,756.40 | $8,314.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,706.82 / $14,706.82 / $15,618.64
| Facility | | $14,706.82 | $14,706.82 | $15,618.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,609.76 / $8,609.76 / $10,763.06
| Professional | | $8,609.76 | $8,609.76 | $10,763.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,886.00 / $7,886.00 / $10,053.49
| Professional | | $7,886.00 | $7,886.00 | $10,053.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,418.01 / $9,418.01 / $9,418.01
| Facility | | $9,418.01 | $9,418.01 | $9,418.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,875.15 / $6,875.15 / $9,418.01
| Professional | | $6,875.15 | $6,875.15 | $9,418.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10,294.77 / $13,236.14 / $17,648.18
| Professional | | $10,294.77 | $13,236.14 | $17,648.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,616.97 / $9,044.95 / $16,432.43
| Facility | | $4,616.97 | $9,044.95 | $16,432.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,060.00 / $19,317.49 / $24,496.82
| Professional | | $8,060.00 | $19,317.49 | $24,496.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,057.43 / $11,041.20 / $16,077.04
| Facility | | $8,057.43 | $11,041.20 | $16,077.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8,057.43 / $11,041.20 / $16,077.04
| Professional | | $8,057.43 | $11,041.20 | $16,077.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,164.85 / $7,164.85 / $7,164.85
| Facility | | $7,164.85 | $7,164.85 | $7,164.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,834.14 / $7,337.07 / $11,020.45
| Professional | | $6,834.14 | $7,337.07 | $11,020.45 |